Leave a request

MEDIFRANCE provides personal information, including data about the Client’s state of health only to the Institutions and Specialists for them to provide their Services, excluding any third party and in no way stores them.

Your personal data

Full name
Gender
Date of Birth

Your address

Country
Zip/Postal code
Address

Your request

What treatment are you interested in
Desired city
Desired date
Personal interpreter
Notes

Your contact info

Phone

Download the treatment form

Please, fill in the treatment form that we could qualitatively process your application.

Order steps

Request
Leave a request
Consultation
Medical records review, help with choosing a clinic, appointment scheduling
Payment
Secure your reservation by making a 100% prepayment
Arrival to France
Arranged travel and accommodation of your choice, accompanied treatment and leisure